[1]张 炜,王 彧.揿针治疗肺肾气虚型慢性阻塞性肺疾病稳定期疗效研究[J].陕西中医,2024,(1):115-119.[doi:DOI:10.3969/j.issn.1000-7369.2024.01.027]
 ZHANG Wei,WANG Yu.Effect of needle therapy in the stable phase of pulmonary and renal qi deficiency chronic obstructive pulmonary disease[J].,2024,(1):115-119.[doi:DOI:10.3969/j.issn.1000-7369.2024.01.027]
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揿针治疗肺肾气虚型慢性阻塞性肺疾病稳定期疗效研究
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《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2024年1期
页码:
115-119
栏目:
针灸经络
出版日期:
2024-01-05

文章信息/Info

Title:
Effect of needle therapy in the stable phase of pulmonary and renal qi deficiency chronic obstructive pulmonary disease
作者:
张 炜1王 彧2
(1.上海中医药大学附属曙光医院肺病科, 上海200021; 2.上海市杨浦区延吉社区卫生服务中心中医科, 上海 200093)
Author(s):
ZHANG WeiWANG Yu
(Department of Pulmonology,Shuguang Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 200021,China)
关键词:
慢性阻塞性肺疾病 稳定期 揿针 肺肾气虚 肺功能 生活质量
Keywords:
Chronic obstructive pulmonary disease Stabilization period Needle picking Lung-kidney qi deficiency type Lung function Quality of life
分类号:
R 563.9
DOI:
DOI:10.3969/j.issn.1000-7369.2024.01.027
文献标志码:
A
摘要:
目的:研究揿针治疗肺肾气虚型慢性阻塞性肺疾病(COPD)稳定期的临床疗效。方法:前瞻性选择COPD患者200例,随机分为两组,对照组给予常规西医治疗,观察组在其基础上加用予揿针治疗,疗程为8周。记录两组的临床疗效,并比较两组治疗前后中医症状积分、6 min步行距离和衰弱筛查量表评分、改良英国MRC呼吸困难指数问卷(mMRC)、肺功能及圣乔治呼吸问卷(SGRQ)评分。两组治疗后均随访6个月,记录两组急性加重的次数。结果:观察组与对照组临床总有效率分别为92.00%和71.00%,前者显著高于后者(P<0.05)。与治疗前比较,两组治疗后中医症状积分和衰弱筛查量表评分均明显降低,6 min步行距离增加(P<0.05),且观察组治疗后中医症状积分和衰弱筛查量表评分低于对照组,6 min步行距离大于对照组(P<0.05)。与治疗前比较,两组治疗后mMRC分级及平均分、SGRQ问卷总分及各维度评分均明显降低,第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、最大呼气流量(PEF)、第1秒用力呼气量/用力肺活量(FEV1/FVC)均明显增大(P<0.05),且观察组治疗后的mMRC分级及平均分、SGRQ问卷总分及各维度评分均低于对照组(P<0.05),肺功能指标高于对照组(P<0.05)。两组治疗后均随访6个月,观察组急性加重次数显著低于对照组(P<0.05)。结论:揿针治疗肺肾气虚型COPD稳定期患者的疗效确定,不仅能改善其临床症状,改善疲劳衰弱状况与增强运动耐量,还能减轻呼吸困难程度并提高肺功能,显著改善生存质量,减少COPD急性发作次数。
Abstract:
Objective:To study the clinical efficacy of needle in the treatment of chronic obstructive pulmonary disease(COPD)with lung and kidney qi deficiency.Methods:A total of 200 patients with COPD diagnosed were divided into 2 groups according to the random number table method,the control group was given conventional western medicine treatment,and the observation group was given needle treatment on the basis of the control group,and the treatment course of both groups was 8 weeks.The clinical efficacy of the two groups was recorded,and the scores of TCM symptoms,6 min walking distance and frailty screening scale,modified British MRC dyspnea index(mMRC),lung function and St.George's Respiratory Questionnaire(SGRQ)before and after treatment were compared.Both groups were followed for 6 months after treatment,and the number of acute exacerbations in both groups was recorded.Results:The clinically effective of the observation group and control group were 92.00% and 71.00%,respectively,and the former was significantly higher than that of the latter(P<0.05).Compared with the pre-treatment period,the TCM symptom score and frailty screening scale scores of the two groups were significantly reduced,and the walking distance increased at 6 min(P<0.05),and the TCM symptom score and frailty screening scale scores in the observation group after treatment were lower than those in the control group,and the walking distance in 6 min was greater than that in the control group(P<0.05).Compared with the pre-treatment period,the mMRC grade and mean score of the two groups after treatment were significantly reduced,and the forced expiratory volume(FEV1),forced vital capacity(FVC),forced expiratory volume/forced vital capacity(FEV1/FVC)and maximum expiratory flow(PEF)in the first second were significantly increased(P<0.05),and the mMRC grade and average score after treatment in the observation group were lower than control group(P<0.05).Compared with before treatment,respiratory symptoms,activity limitation,disease impact scores and total scores in the SGRQ questionnaire were significantly lower in the two groups after treatment.Both groups were followed for 6 months after treatment.Conclusion:The efficacy of acupuncture in the treatment of patients with stable COPD with lung and kidney qi deficiency can not only improve clinical symptoms,exercise capacity and fatigue and debilitation,but also improve lung function and relieves breathing difficulties,significantly improve quality of life,and reduce the number of acute episodes of COPD.

参考文献/References:

[1] 贾存波,黄可,张春瑜,等.我国18个地市慢性阻塞性肺疾病诊疗能力现状调查[J].中国临床医生杂志,2021,49(6):669-671.
[2] 薛佩妮,冯敏娟,王惠琴.噻托溴铵粉联合糖皮质激素治疗慢性阻塞性肺疾病疗效及对患者生活质量评分的影响[J].陕西医学杂志,2020,49(2):216-219.
[3] LANDIS S,SURUKI R,MASKELL J,et al.Demographic and clinical characteristics of COPD patients at different blood eosinophil levels in the UK clinical practice research datalink[J].COPD,2018,15(2):177-184.
[4] 唐万云,曾玉英,汪秀玲,等.益气活血方治疗慢性阻塞性肺疾病稳定期疗效及对患者肺功能、炎症因子的影响[J].陕西中医,2020,41(11):1576-1579,1583.
[5] 王雅宁,米婷,周红.不同通气模式治疗慢性阻塞性肺疾病合并呼吸衰竭临床疗效及患者呼吸动力学、肺功能水平比较[J].陕西医学杂志,2023,52(1):36-39,44.
[6] 高思华,王键.中医基础理论[M].北京:人民卫生出版社,2013:224-225.
[7] 中华医学会呼吸病学分会慢性阻塞性肺疾病学组.慢性阻塞性肺疾病诊治指南(2013 年修订版)[J].中华结核和呼吸杂志,2013,36(4):255-264.
[8] 中华中医药学会内科分会肺系病专业委员会.慢性阻塞性肺疾病中医诊疗指南(2011版)[J].中医杂志,2012,53(1):80.
[9] 国家食品药品监督管理局.中药新药临床研究指导原则试行[M].北京:中国医药科技出版社,2002:378-380.
[10] 中华医学会老年医学分会.老年患者6分钟步行试验临床应用中国专家共识[J].中华老年医学杂志,2020,39(11):1241-1250.
[11] 侯苹,薛慧萍,李永男,等.FRAIL量表在筛查老年冠心病伴衰弱患者中的应用价值研究[J].中国全科医学,2019,22(9):1052-1056.
[12] 谢柏梅,敬梅,张彦海,等.慢性阻塞性肺疾病临床问卷对稳定期慢性阻塞性肺疾病生活质量的评价[J].解放军医药杂志,2017,29(4):41-44.
[13] 陈浩,王莹.圣乔治呼吸问卷评估慢性阻塞性肺疾病患者生活质量的价值[J].安徽医学,2014,35(8):1052-1054.
[14] 王永,刘亚玲,刘大凤,等.参杞归陈汤联合肺康复治疗对稳定期慢阻肺患者预后及生活质量影响的研究[J].陕西中医,2018,39(10):1378-1380.
[15] 张卓红,赵拖利.慢性阻塞性肺疾病大鼠血液、支气管灌洗液中水通道蛋白及p-c-Jun-N-末端激酶表达情况实验研究[J].陕西医学杂志,2021,50(7):776-779.
[16] GRANGER C L,MORRIS N R,HOLLAND A E.Practical approach to establishing pulmonary rehabilitation for people with non-COPD diagnoses[J].Respirology,2019,24(9):879-888.
[17] 梁国玲,李彬,刘粉玲,等.不同灸量的脐灸疗法对慢阻肺稳定期患者SGRQ评分及肺功能的影响[J].天津中医药大学学报,2021,40(4):467-471.
[18] MARENGONI A,VETRANO D L,MANES-GRAVINA E,et al.The relationship between COPD and frailty:A systematic review and meta-analysis of observational studies[J].Chest,2018,154(1):21-40.
[19] 罗佳,汤雯,章岱,等.衰弱与慢性阻塞性肺疾病的相关性研究进展[J].中国实用内科杂志,2022,42(3):247-250.
[20] 高锋,冯妮,王芹.浮针联合揿针治疗面肌痉挛 32 例[J].中国针灸,2020,40(6):643-644.
[21] 赖永贤,陈佳,沈芳,等.无菌揿针治疗带状疱疹后遗神经痛的临床观察[J].辽宁中医杂志,2019,46(6):1278-1280.
[22] 罗志辉,王昆秀,张艳琳,等.“ 标本配穴” 揿针治疗新型 冠状病毒肺炎恢复期后遗症疗效观察[J].中国针灸,2022,42(3):281-286.
[23] 全亚林,牛彩琴.牛彩琴以揿针结合中药治疗阳虚水泛证肺胀经验[J].山东中医杂志,2022,41(3):329-333.
[24] 贺建豪,黄培炜,许金森,等.揿针疗法对慢阻肺模型大鼠气道形态学及氧化水平的影响[J].山西中医药大学学报,2022,23(1):17-21.
[25] 秦丰,潘宏达,吕爽,等.苏黄止咳胶囊对大鼠慢阻肺模型NF-κB p65、TLR4及IAP1表达的影响[J].中国中医基础医学杂志,2021,27(2):293-297.

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备注/Memo

备注/Memo:
基金项目:国家自然科学基金资助面上项目(81673900); 上海市杨浦区科技委员会科研项目(YPZQ202111)
更新日期/Last Update: 2024-01-09